Abstract
BackgroundWe hypothesize that implantation of left ventricular assist device through off-pump technique is feasible and has a comparable result to implantation on cardiopulmonary bypass and could improve one-year survival.MethodsThis retrospective, observational, single-center study was conducted on 29 consecutive patients at our institution who underwent off-pump left ventricular assist device implantation by a single surgeon.ResultsTwenty-seven procedures were performed successfully using the off-pump technique. The survival rate was 92% at 30 days, 76% at 90 days, and 67% at one year. We compared the one-year survival of different implantation periods, and divided our study into three time intervals (2004-2005, 2006, and 2007). There was a trend in reduction in number of deaths over one year that demonstrated a decrease in death rate from 50% to 17%, as well as improvement in our experience over time. However, this trend is not statistically significant (p = 0.08) due to limited sample size.ConclusionsBased upon our findings, off-pump left ventricular assist device implantation is a feasible surgical technique, and combining this technique with improved device technology in the future may provide even greater improvement in patient outcomes.
Highlights
We hypothesize that implantation of left ventricular assist device through off-pump technique is feasible and has a comparable result to implantation on cardiopulmonary bypass and could improve one-year survival
Perioperative complications result from a combination of three factors: 1) intrinsic heart failure with secondary organ damage; 2) long-term effect of the implanted device; and 3) surgical techniques employed, including cardiopulmonary bypass (CPB)
Of the 29 cases scheduled for off-pump left ventricular assist device (OP LVAD), 27 cases were successfully performed with 18 patients as BTT and 7 as destination therapy
Summary
We hypothesize that implantation of left ventricular assist device through off-pump technique is feasible and has a comparable result to implantation on cardiopulmonary bypass and could improve one-year survival. Left ventricular assist devices were approved as a bridge to transplantation therapy (BTT) in 1998 [1]. In 2001, they became a destination therapy in the United States [2]. Perioperative complications result from a combination of three factors: 1) intrinsic heart failure with secondary organ damage; 2) long-term effect of the implanted device; and 3) surgical techniques employed, including cardiopulmonary bypass (CPB). CPB has advantages such as inspecting left ventricle for thrombus, hemodynamic resuscitation, and removing fluid, including ultrafiltrations on CPB, but it may have unwanted effects as well, such as increasing systemic inflammatory response and transfusion requirements. The experimental and clinical data comparing on-pump and off-pump coronary surgery suggest an affected cardiac function in favor of off-pump
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
